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Migraines & Headaches Health Center

Power of Suggestion Shown in Study of Migraine Drug

Expectation plays important role in response to treatment, expert says
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The three situations were labeled by the researchers as positive (meaning a drug that could help with migraine symptoms was provided), negative (meaning no drug, only a placebo pill was provided), or neutral (meaning it was unknown if the drug or placebo pill was within the envelope). But for two situations, one of the "Maxalt" envelopes actually held a placebo and one of the "placebo" envelopes contained Maxalt.

The participants were asked to self-report their responses to treatment over the course of their next six migraine episodes.

Dr. Ted Kaptchuk, a senior author of the study, said that even though Maxalt was superior to the placebo in terms of alleviating pain, "we found that under each of the three messages, the placebo effect accounted for at least 50 percent of the subjects' overall pain relief."

When Maxalt was labeled "Maxalt," the patients' reports of pain relief more than doubled compared to when Maxalt was labeled "placebo," said Kaptchuk, a professor of medicine at Harvard. "This tells us that the effectiveness of a good pharmaceutical may be doubled by enhancing the placebo effect," he said.

When patients received Maxalt labeled as placebo, they were being treated by the medication but without any positive expectation, the other senior author, Rami Burstein, a professor of medicine at Harvard, said in a Beth Israel news release. "This was an attempt to isolate the pharmaceutical effect of Maxalt from any placebo effect," Burstein said.

The authors were surprised to find that even when patients were given a placebo labeled as "placebo," they reported pain relief, compared with no treatment.

"We don't know what that's about. It's a novel finding," added Kaptchuk.

Charles said the study was interesting and confirms what many experts believe about the placebo effect. "It's more rigorous than perhaps a number of the other studies that have been done previously," he noted.

Could these results play out across the spectrum of medical care?

"Obviously we don't know, we only looked at migraine," said Kaptchuk, "but I think that in many categories of illness and drugs, this would be proof of concept.

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